Individual
JOHN SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
420 E 76TH ST, NEW YORK, NY 10021-3396
(212) 434-5301
Mailing address
2422 STUART AVE, APT 2A, RICHMOND, VA 23220-3414
(804) 307-1355
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401947-1
NY
Other
Enumeration date
12/15/2015
Last updated
12/15/2015
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